电子健康、积极情绪技能干预对提高青年癌症幸存者心理幸福感的效果：多中心、初步可行性试验的结果。
An eHealth, Positive Emotion Skills Intervention for Enhancing Psychological Well-Being in Young Adult Cancer Survivors: Results from a Multi-Site, Pilot Feasibility Trial.
机构信息
Department of Social Sciences and Health Policy, Wake Forest University School of Medicine & Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
Department of Behavioral Science and Center for Health Equity Transformation, University of Kentucky College of Medicine, Lexington, KY, USA.
出版信息
Int J Behav Med. 2023 Oct;30(5):639-650. doi: 10.1007/s12529-023-10162-5. Epub 2023 Mar 8.
BACKGROUND
Young adult (YA) cancer survivors experience clinically significant distress and have limited access to psychosocial support. Given growing evidence for unique adaptive benefits of positive emotion in the context of health-related and other life stress, we developed an eHealth positive emotion skills intervention for post-treatment survivors called EMPOWER (Enhancing Management of Psychological Outcomes With Emotion Regulation) and evaluated feasibility and proof of concept for reducing distress and enhancing well-being.
METHOD
In this single-arm pilot feasibility trial, post-treatment YA cancer survivors (ages 18-39) participated in the EMPOWER intervention which included 8 skills (e.g., gratitude, mindfulness, acts of kindness). Participants completed surveys at baseline (pre-intervention), 8 weeks (post-intervention), and 12 weeks (1-month follow-up). Primary outcomes included feasibility (assessed by participation percentage) and acceptability (would recommend EMPOWER skills to a friend). Secondary outcomes included psychological well-being (mental health, positive affect, life satisfaction, meaning/purpose, general self-efficacy) and distress (depression, anxiety, anger).
RESULTS
We assessed 220 YAs for eligibility; 77% declined. Of those screened, 44 (88%) were eligible and consented, 33 began the intervention, and 26 (79%) completed the intervention. Overall retention was 61% at 12 weeks. Average acceptability ratings were high (8.8/10). Participants (M = 30.8 years, SD = 6.6) were 77% women, 18% racial/ethnic minorities, and 34% breast cancer survivors. At 12 weeks, EMPOWER was associated with improved mental health, positive affect, life satisfaction, meaning/purpose, and general self-efficacy (ps < .05, ds = .45 to .63) and decreased anger (p < .05, d = - 0.41).
CONCLUSION
EMPOWER demonstrated evidence of feasibility and acceptability as well as proof of concept for enhancing well-being and reducing distress. Self-guided, eHealth interventions show promise for addressing YA cancer survivors' needs and warrant additional research to optimize survivorship care.
TRIAL REGISTRATION
ClinicalTrials .gov NCT02832154, https://clinicaltrials.gov/ct2/show/NCT02832154.
背景
青年癌症幸存者（YA）经历了显著的临床困扰，并且获得的心理社会支持有限。鉴于积极情绪在与健康相关和其他生活压力的背景下具有独特的适应性益处的证据越来越多，我们为接受过治疗的幸存者开发了一种名为 EMPOWER 的电子健康积极情绪技能干预措施（通过情绪调节增强心理结果管理），并评估了降低困扰和提高幸福感的可行性和概念验证。
方法
在这项单臂试点可行性试验中，接受过治疗的 YA 癌症幸存者（18-39 岁）参加了 EMPOWER 干预措施，该措施包括 8 项技能（例如感恩、正念、善举）。参与者在基线（干预前）、8 周（干预后）和 12 周（1 个月随访）完成调查。主要结果包括可行性（通过参与百分比评估）和可接受性（是否会向朋友推荐 EMPOWER 技能）。次要结果包括心理幸福感（心理健康、积极情绪、生活满意度、意义/目的、一般自我效能感）和困扰（抑郁、焦虑、愤怒）。
结果
我们评估了 220 名 YA 的资格；77%的人拒绝了。在筛选出的人中，44 人（88%）符合条件并同意参加，33 人开始接受干预，26 人（79%）完成了干预。12 周时的总体保留率为 61%。平均可接受性评分很高（8.8/10）。参与者（M=30.8 岁，SD=6.6）中 77%为女性，18%为少数族裔，34%为乳腺癌幸存者。在 12 周时，EMPOWER 与心理健康、积极情绪、生活满意度、意义/目的和一般自我效能感的改善有关（p<0.05，ds=0.45 至 0.63），与愤怒的减少有关（p<0.05，d=-0.41）。
结论
EMPOWER 证明了可行性和可接受性的证据，以及增强幸福感和减少困扰的概念验证。自我指导的电子健康干预措施显示出满足 YA 癌症幸存者需求的潜力，需要进一步研究以优化生存护理。
试验注册
ClinicalTrials.gov NCT02832154，https://clinicaltrials.gov/ct2/show/NCT02832154。
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